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A Retrospective Comparative Study of Primary Versus Revisional Roux-en-Y Gastric Bypass: Long-Term Results

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Abstract

Aims

To compare the perioperative parameters and excess weight loss between patients operated by laporoscopic Roux-en-Y gastric bypass (LRYGB), as a primary operation or a revisional, for insufficient weight loss after vertical banded gastroplasty (VBG) or adjustable gastric banding (AGB).

Methods

A retrospective analysis of all patients who underwent a LRYGB was performed for the period 2004–2011. Demographics, preoperative body mass index (BMI), co-morbidities, operation time, conversion rate, perioperative complications, hospitalization period, and % of excess BMI loss (%EBMIL) were investigated and compared between groups.

Results

Three hundred forty-two laparoscopic gastric bypass operations were performed, 245 were primary, and 97 revisional. Median follow-up was 30 months (range 0–108 months). Mean BMI (kg/m2) before bypass was 45.2 for primary laparoscopic Roux-en-Y gastric bypass (pLRYGB) and 41.1 for revisional laparoscopic Roux-en-Y gastric bypass (rLRYGB). Median operative time and length of stay were longer for rLRYGB 157.5 versus 235 min (p < 0.001) and 6 versus 6.5 days (p = 0.05). Conversion to laparotomy was performed in eight patients, 0.4% of primary and 7.2% of revisional. Morbidity rate was 6.5% in pLRYGB versus 10% in rLRYGB (NS). There was one death in the primary group. Percentage of EBMIL was significantly lower in the revisional group at 12, 18, and 24 months of follow-up.

Conclusions

Revisional and primary gastric bypass have no statistical differences in terms of morbidity. The % of excess BMI loss is lower after revisional gastric bypass during the first 2 years of follow-up. The trend of weight loss or weight regain was similar in both groups.

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Authors and Affiliations

  1. CH Jolimont-Lobbes site Lobbes, Rue de la Station 25, 6540, Lobbes, Belgium

    Dimitrios Dardamanis

  2. Oesogastroduodenal and Bariatric Unit, Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200, Brussels, Belgium

    Dimitrios Dardamanis, Julie Navez, Laurent Coubeau & Benoit Navez

Authors
  1. Dimitrios Dardamanis
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  2. Julie Navez
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  3. Laurent Coubeau
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  4. Benoit Navez
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Contributions

Dimitrios Dardamanis: has done the study design and the data collection, and participated in the operations and follow-up consulting and writing of the manuscript.

JulieNavez: data collection, follow-up consulting, and data analysis.

Laurent Coubeau: data collection and follow-up consultation.

Benoit Navez: has performed all the operations, coordinated the team, final corrections.

All authors approve the final version of the submission.

Corresponding author

Correspondence to Dimitrios Dardamanis.

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Conflicts of Interest Statement

The authors declare that they have no conflict of interest.

Ethical Approval Statement

For this type of study, formal consent is not required.

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Dardamanis, D., Navez, J., Coubeau, L. et al. A Retrospective Comparative Study of Primary Versus Revisional Roux-en-Y Gastric Bypass: Long-Term Results. OBES SURG 28, 2457–2464 (2018). https://doi.org/10.1007/s11695-018-3186-z

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  • DOI: https://doi.org/10.1007/s11695-018-3186-z

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